REFLECTIVE PRACTICE HANDOUT - ATTACHMENT IS THAT PROCESS BY WHICH WE COME TO LIVE IN THE MIND AND ... to own instead of split it off. ... REFLECTIVE PRACTICE –CORE IDEAS

REFLECTIVE SUPERVISION: TO LIVE

IN THE MIND AND HEART OF

ANOTHER

United Way of Tucson and Southern Arizona

7th Annual Family Support Conference

May 25th, 2017

Kenny E. Miller, ACSW, LCSW5671 N. Oracle Rd., Suite 2101

Tucson, AZ 85704(520)326-8424

[email protected]

HOW COMES ATTACHMENT?“ATTACHMENT IS THAT PROCESS BY WHICH WE COME TO LIVE IN THE MIND AND

HEART OF ANOTHER”

“ATTACHMENT IS FORMED FROM THE MOMENT TO MOMENT DYADIC REGULATION OF AFFECT THROUGH PSYCHOBIOLOGICAL STATE ATTUNEMENT”

(Quite a scientific mouthful!)

Mirroring, Attunement, Shared Affect and Contingent Communication

◊ Mirroring is the reflecting back of the emotional signals and cues received through the body posture, gesture tone and words.

◊ Attunement is the bracketing of emotional experience and awareness of the caregiver themselves, to create a space to receive the child’s signals and experience. Allows the self of caregiver to vibrate at the same wavelength of the child: to attune.

◊ Shared Affect is what happens when what lives inside of me, also lives inside another, my subjective experience is shared, we vibrate at the same emotional level. For the child, this allows them to be validated for the truth of their feeling, to own instead of split it off.

◊ Contingent Communication is the response of the caregiver to the child’s signal which matches that signal in quality, intensity and timing. Creates a coherence of self in child between what was felt before the signal and what they feel afterwards. Also coherence with the person the signal was sent to.

In this way children come to “feel felt”, they come to feel as if they exist in the mind of their parent. Self knowledge in part becomes a co-constructive and collaborative process.

“It takes two to know one” – D. W. Winnicott

2009 All Rights Reserved Kenny E. Miller, ACSW, LCSW [email protected]

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SHOW VIDEO

Tronick – Split Screen Mom and Baby


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REFLECTIVE PRACTICE – CORE IDEAS

◊ SLOWING DOWN – NO HYDROPLANING

◊ USE OF BREATH

◊ CREATING A PURPOSE OR FRAME TO CREATE SAFETY

◊ TAKING THE PERSPECTIVE OF THE OTHER

◊ ABILITY TO NOT REALLY KNOW

◊ ABILITY TO SELF MONITOR/STOP

◊ TRUE CURIOSITY

◊ OPENING SPACE AROUND CONCERNS

◊ AWARENESS OF SELF AND OTHERS

◊ OPEN EXPLORATION WITH SELF AND OTHERS

◊ RESPECT FOR DIFFERENCESCore ideas created by Mary Clare Heffron, Ph.D.

2009 All Rights Reserved Kenny E. Miller, ACSW, LCSW

[email protected]

REFLECTIVE SUPERVISIONUnderstanding the concept of “parallel process”:

The same model for growth and development that starts with the infant, applies also to the child’s parent and applies also to the provider of services!

Universal human needs for:

Support and emotional validation

Competence and mastery

Connectedness to others

Reflective supervision is the “holding environment” for workers which provides a “secure base” in which to explore feelings about families and self. Uncover and discover solutions to problems in a mutual way with supervisor.

continued next slide…


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REFLECTIVE SUPERVISION

Understanding the concept of “parallel process”: (continued)

Acknowledges the intensity and the emotional impact of the work with families, the exposure to the losses, trauma, etc. which these families have experienced and continue to experience.

Completes the cycle of care for families, workers will become burnt out quickly without appropriate emotional support and recognition of their efforts. Families ultimately suffer with high turnover of workers, for example.


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REFLECTIVE SUPERVISION - PARALLEL PROCESS

SUPERVISON

THERAPIST

PARENT

CHILD

“BEING WITH”

•Attunement•Mirroring•Validation•Support

A universal understanding of how we grow as human beings

We offer the worker the same experience we want themto offer the parent

Provides support, sort out and organize the emotional world

Rescue from overwhelming, stuck and powerless place

Together create a plan, problem-solve, find a way out

We can offer the same support as colleagues to each otheron an “informal” basis, debrief and use the principles

REFLECTIVE SUPERVISION – A RELATIONSHIP FOR GROWTH

Regular and Predictable -- you can count on it!

● Someone extends themselves to organize their life so that I matter. I get my time.

Shares Power and Reduces Hierarchy

● Acknowledges mentorship, someone who is ahead of me in experience and learning about the practice of relationship-based work.

● Maybe they actually do have more years of experience (ideally!) but maybe they don’t, then what??!!

A Truly Collaborative Process

● The relationship starts by seeking to understand my experience, to validate my experience, and to support my strengths and skills in my work.

● Assumes that I am the expert on the family that we will discuss because of all the time and shared experience with them that I have.

● Together we can explore, be curious, and wonder about the process of the family, and about their impact on me.

● Together create a plan of action if needed for practical reasons.

The Power of “Parallel Process”

● What best supports my growth as a worker, models and releases skills which will provide the best outcomes for families. Continued next slide…..


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REFLECTIVE SUPERVISION – A RELATIONSHIP FOR GROWTH

…..continued from previous slide

A safe place to learn about ourselves in relationship – both the relationship with families and just HOW they are coming to live in my mind and heart, as well as the relationship with supervisor, one of concern and support for my growth.

The willingness to explore, wonder, be curious and REFLECT, or step back from the moment to moment interaction with clients, and learn about how they are impacting me.

To experience a relationship that offers mirroring, attunement, support and being valued: someone who can “hold” what I’ve got, stay separate and not rescue or criticize, and together we find a satisfying way for me to “Be With” the family, deepens the “reflective function” of me as a worker.

Different boundaries and focus from personal psychotherapy: the intent end goal is always the growth of the family, not solely the growth of the family educator.


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WHY THE NEED? SPECIAL NEEDS OF IN-HOME WORKERS

The “Professional Use of Self” in relationship-based work requires a unique form of support and growth for the workers’ success and ultimately the family’s success.

The nature of overwhelming experience: stored in the body/memory and when family educators encounter the stories and overwhelmed parts of families, they cannot help but be activated if similar experience has been a part of their life. This cannot help but distort their responses and support to the family.

When you go into the family’s home as your place of work, you give up control of your environment, which most professionals assume in their settings of work.

Continued on next slide…..


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WHY THE NEED? SPECIAL NEEDS OF IN-HOME WORKERS

…continued from previous slide

The unpredictability of the HIGH RISK FAMILY environment, and the challenges of working in an environment where you are not supposed to be “in charge” but rather offering a relationship of collaboration and support, which by it’s nature means respecting the needs of the family first.

The emotional intensity of the work: family educators typically are asked to hold the stories of the families and parents that are very traumatic, and the fact of “vicarious traumatization” of the family educator, which may be unconscious.

The emotional ISOLATION of the work: there is often no one in the family educator’s world who has similar work, by confidentiality you are supposed to keep it private, it’s unique and very hard to describe and share with others the nature of just what it is you “DO” for a living!!


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BARRIERS TO REFLECTIVE SUPERVISION

There are two MAIN barriers to reflective supervision and they are:

The structure of agencies and organizational charts which decide who will “supervise” the family educator and the deeply important issue of separating out the official “evaluation” of the family educator’s “performance” from the reflective supervision they need for professional and personal growth.

The size and volume of agency caseloads make regular supervision a challenge to accomplish!!


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THE FOCUS IN REFLECTIVE SUPERVISION:

GROWTH OF SELF-AWARENESS IN PROVIDER

“Reflective Supervision is a collaborative process in which both parties co-create a flow of conversation whose purpose is to more easily access the UNRECOGNIZED and UNEXAMINED sensations caused by “Being With” an infant and their caregivers.”

Coming out of the “ocean” of implicit memory, out of the “conditioned self”, these sensations do not arise with a presence of “I remember this from the past”. Instead they seem like tiny real-time beliefs, statements, slips, gestures, and subtle feeling states that can be easily dismissed in the workers common urgency to “figure out what to do next”

Michigan Association for Infant Mental Health - Supervision

2014 All Rights Reserved Kenny E. Miller, ACSW, LCSW www.attachmentskills.com

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THE FOCUS IN REFLECTIVE SUPERVISION:

GROWTH OF SELF-AWARENESS IN PROVIDER

Those places where the provider feels a pressure to “do something” and move off of a feeling, tension, conflict that exists – difficult to tolerate strong affect.

Known as “presses”, “hotspots” or “triggers”, they are the ways we cannot help ourselves but find ourselves behaving in over-determined ways

Coming out of the “ocean” of implicit memory, the “conditioned self”, by definition we are not aware

When acted upon these parts of ourselves leave family/parent NOT feeling seen, heard, felt.

2014 All Rights Reserved Kenny E. Miller, ACSW, LCSW www.attachmentskills.com

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KNOW THY HOT SPOTS

This and following illustrative slides taken from the work of Mary Clare Heffron, Ph.D.


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KNOW THY TRIGGERS


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The Need to Be a HeroThe “Rescue” Fantasy


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THE NEED FOR A QUICK FIXTHE FIX-ALL FANTASY


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THE NEED FOR IMMEDIATE CHANGETHE “RIGHT AWAY” FANTASY


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THE NEED TO MAKE NICETHE “CHEERLEADER” FANTASY


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THE NEED TO CONCEAL AND SUPPRESSTHE “QUICK COVER-UP” FANTASY


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LET’S PRETENDTHE THESPIAN FANTASY


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THE NEED TO TAKE OVERTHE “KING OF THE MOUNTIAN” FANTASY


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THE NEED TO PLEASETHE “WE’RE PALS” FANTASY


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THE “MY WORLD VIEW PREVAILS” FANTASY


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HYDROPLANING – THE OPPOSITE

OF

REFLECTIVE PRACTICE

THERE IS OFTEN A STRONG PULL TO FIX, SOOTHE, PROBLEM SOLVE OR TELL THAT LEADS OTHERS TO FEEL THEY ARE NOT SEEN OR HEARD.


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REFLECTIVE PRACTICE HANDOUT - ATTACHMENT IS THAT PROCESS BY WHICH WE COME TO LIVE IN THE MIND AND ... to own instead of split it off. ... REFLECTIVE PRACTICE –CORE IDEAS